There’s one big question Republicans haven’t answered in their bill to replace Obamacare: How would members of Congress and their staffs get their own health insurance plans?
“Like everything else in or left out of this bill, the answer to that question is probably still in Donald Trump’s head,” said Democratic Rep. Emanuel Cleaver of Missouri.
Members of Congress haven’t been told whether they and their employees will be exempt from any changes or what their situation would be, Cleaver told McClatchy.
“It may mean we go back to the way things were,” he said.
Right now, members of Congress and their staffs must use the Obamacare exchange market in the District of Columbia, a requirement intended to make them subject to the same health care overhaul they passed for the rest of the country. But the proposal from House Speaker Paul Ryan, R-Wis., doesn’t address the issue, and not even Republican lawmakers can say for sure what will happen to their coverage.
If Congress repeals the ACA, here's how employer-based health care could change
Before passage of the Affordable Care Act — also known as Obamacare — lawmakers and their staffers were eligible for the health plans offered to all federal employees. Those plans were subsidized by a pretax employer contribution from the government.
During debate over Obamacare in 2010, Republican Sen. Chuck Grassley of Iowa offered an amendment that required members of Congress and their staffs to purchase coverage on the public exchanges created by the law. Democrats agreed, and the measure became part of the law.
But not before closed-door negotiations in which party leaders agreed to exempt Senate committee and leadership staffs from the requirement.
Under Obamacare, members of Congress and those who work in their personal offices do not receive income-based subsidies to help cover the cost of their health plans, as do other Americans who buy plans on the exchanges.
Instead, they get a different deal: A special exemption from the U.S. Office of Personnel Management allows them to use the pretax contribution from their employer, the federal government, to buy health plans on Washington’s small-business exchange.
That contribution could be worth as much as 75 percent of any given plan’s premium, or anywhere from about $170 to more than $500 per month for an individual, according to the Congressional Research Office.
The salary for a rank-and-file member of Congress is $174,000 a year.
The bill Republicans introduced earlier this month to repeal and replace Obamacare, the American Health Care Act, does not address how lawmakers and their staffers would get their health insurance.
For now, the Office of Personnel Management has no information on how congressional staff may be affected by any pending legislation regarding Obamacare, said spokeswoman Laura Goulding.
The issue isn’t mentioned because Republicans are trying to fast-track the bill under a special parliamentary rule in the Senate that will allow the legislation to pass by a simple majority vote, according to Zach Hunter, spokesman for the Committee on Energy and Commerce in the House of Representatives.
That rule, known as budget reconciliation, requires that the bill have no effect on the federal budget, either in terms of spending or revenue.
Adding language about how members of Congress and their staffs buy health insurance could make the bill ineligible under the rule, Republicans say.
The issue will have to be addressed in a future health care bill. So far, Republicans haven’t unveiled one.
“It’s a little too early to tell what the content of that bill would look like and whether amendments would be possible,” Jill Gerber, a spokeswoman for Grassley, said in an email.
Grassley said in a statement that he still thinks members of Congress need to be subject to the laws they pass for the rest of the country.
“Congress ought to be held to the same set of standards as everyone else,” Grassley said. “That’s especially true when laws remake a system and introduce expense and uncertainty, as we saw with Obamacare.”
Grassley said he was glad to succeed in applying Obamacare to members of Congress and their staffs but frustrated by carve-outs that kept it from applying to powerful Senate committee and leadership staffs or the White House itself.
“At this point, I’m standing by to see what the new Obamacare replacement bill looks like and what kind of opportunity there might be to apply the changes to Congress, staff and the White House,” Grassley said.
If future legislation were to create a different standard for Congress from the rest of America, someone likely would “come forward with a pretty strong amendment,” said Sabrina Corlette, a research professor at Georgetown University Health Policy Institute.
“There are going to be people watching pretty closely to make sure they aren’t giving each other any special deals,” Corlette said.
Still, Corlette doesn’t think lawmakers will get rid of their employer-based coverage anytime soon — even though the Republican bill would end Obamacare’s requirement that private-sector employers offer affordable health plans.
Republicans say they’re focused on repealing and replacing Obamacare, not on the fate of their own coverage.
Republican Rep. Mark Walker of North Carolina’s “last concern right now is his own health insurance or the health insurance of his staff,” said his spokesman, Jack Minor.
The priority for Walker, who chairs the conservative Republican Study Committee, is making health care more affordable and accessible for North Carolina families, Minor said in an email.
“Congressman Walker firmly believes that Congress should under no circumstances get special treatment in health care, or any other area,” he said.
Some of the most outspoken Republican critics of Obamacare, such as conservative Sen. Ted Cruz of Texas, either decline coverage or purchase plans on the private insurance market rather than accept the government contribution toward their Obamacare premiums. Others, like Missouri’s Republican Sen. Roy Blunt, buy their plans on the exchange but donate the government contribution to charity.
Neither Cruz nor Blunt responded to requests for comment on whether they would accept the subsidies if they succeed in repealing Obamacare and replacing it with the Republican plan.
William Douglas contributed to this report.